Mental Health America of Greater

July 2017 Previous Legislative Sessions

83rd Legislative Session: January 8, 2013 - May 27, 2013 84th Legislative Session: January 13, 2015 - June 1, 2015

Source: http://www.lrl.state.tx.us/whatsNew/client/index.cfm/Legislative-process 85th Regular Session

January 10, 2017 - May 29, 2017

Leadership: Governor: Greg Abbott (R) Lieutenant Governor: Dan Patrick (R) Speaker of the House: Joe Straus (R – San Antonio)

Bill Statistics for the 85th Legislature

Source: http://www.lrl.texas.gov/sessions/sessionSnapshot.cfm?legSession=85-0 Biennial Revenue Estimate (BRE): 2018 – 2019

General Revenue Fund: $104.9 billion • ~ 7 billion less than allocated for 2015 Rainy Day Fund: $12 billion

When presented, estimates suggested $109 billion in General Revenue monies would be required to fund programs at established levels.

*Prop 7, passed by tax payers in 2015, required the state to dedicate up to $5 billion in sales tax revenue to the State Highway Fund.

Source : www.texastribune.org/2017/01/09/hegar-gives-lawmakers- dour-revenue-estimate-2017 Base Budget Breakdown: SB 1/HB 1

Senate House Finance Chairman Jane Nelson filed SB 1, which serves Texas House Speaker Joe Straus filed HB 1, the as the Senate’s base budget and establishes state House’s initial 2018-2019 budget. funding priorities for the next two years. HB 1 includes: •SB 1 includes: – $108.9 billion in general fund allocations, – $103.6 billion of general state funding with overall approximately $4 billion more than the spending — including federal and other funds — of Comptroller’s estimated available revenue, and a $213.4 billion. total budget of $221.3 billion.

Total difference: 5.3 billion in general state funding Final Budget

SB 1 includes: – 2018-2019: $217 billion • Total General Revenue spending: $107.8 billion — approximately the same amount as the 2016-2017 budget ($108 billion). • The final deal: – Defers $1.8 billion of Prop 7 funds until FY 2020 – allowing $1.8 billion to be counted as General Revenue available in 2018-2019. – Draws down less than $1 billion from the $10 billion Rainy Day Fund to be used almost entirely for state facilities repairs, construction and equipment purchases. – Behavioral Health Funding: • $160 million added for various community-based services and projects • $35 million increase approved for state hospital operations, and • $300 million from the Rainy Day Fund to be used for state hospital repairs and construction -- “HHSC shall develop a comprehensive inpatient mental health plan for the replacement or significant repair of state hospitals or other state- funded inpatient mental health facilities to expand inpatient mental health capacity over the next three biennia.”

Source: http://bettertexasblog.org/2017/05/first-look-2018-2019-texas-budget/ Local Burden of Unmet Mental Health Needs on Texas Counties

Source: http://texasstateofmind.org/wp-content/uploads/2015/11/TexasCUC_UnmetNeeds_Handout_FINAL-43464.pdf House Select Committee on Mental Health

Speaker Joe Straus appointed the Select Committee in November 2015 Members: – Representative (R-Amarillo), Committee Chair – Representative (D-El Paso), Vice Chair – Representative (R-Friendswood) – Representative (D-Houston) – Representative Sarah Davis (R-Houston) – Representative Rick Galindo (R-San Antonio) – Representative Sergio Munoz (D-Palmview) – Representative Andy Murr (R-Junction) – Representative (D-Dallas) – Representative Kenneth Sheets (R-Dallas) – Representative Senfronia Thompson (D-Houston) – Representative Chris Turner (D-Grand Prairie) – Representative James White (R-Hillister)

The Select Committee led 8 public hearings: Link to the Report - Mental Health Overview (1) - Mental and Behavioral Health Services and Treatments For Children (2) - Mental and Behavioral Health Services and Treatment Access, Continuity of Care, Coordination, and Workforce (3,4) - Insurance Coverage and Parity and Law Enforcement (5) - Substance Abuse, Homelessness, and Veterans (6) - Public Testimony (7) - State Hospitals, Options for Addressing Needs, and Mental Health Care on Campuses of Higher Education (8)

Source: www.house.state.tx.us/_media/pdf/committees/reports/84interim/Mental-Health-Select-Committee-Interim-Report-2016.pdf House Select Committee On Mental Health: Opportunities to Solve Existing Service Gaps • Prioritizing early intervention and prevention measures – especially among school age children

• Expanding innovative public school-based programs

• Sustainability of the 1115 Transformation Waiver / DSRIP funded programs

• Expanding bed capacity by expanding step-down beds to provide a continuum of care – Part of this is expanding jail diversion programs for nonviolent offenders

• Continuing to address mental health workforce shortages through educational incentives and by expanding the availability and utilization of technology, such as telemedicine – Truly integrating healthcare to treat the whole person- physically & mentally • Rep. Four Price (R- Amarillo) understands issues related to IHC. Questions remain among the committee surrounding the implementation.

Source: www.house.state.tx.us/_media/pdf/committees/reports/84interim/Mental-Health-Select-Committee-Interim-Report-2016.pdf Impact: House Select Committee on Mental Health

- Increased focus on a prevention model of care

- A more strategic and holistic approach to Mental Health and Behavioral Health funding

- Engaged group of advocates with the House, increasing Mental Health and Behavioral Health focused bills filed

Mental Health & Substance Abuse (I0019) Status HB SB Total Filed 122 67 189 Passed 16 17 33 Vetoed 0 1 1

Source: http://www.capitol.state.tx.us/Home.aspx Spotlight: Mental Health and Behavioral Health

BILL # AUTHOR CAPTION STATUS Price | Bonnen, Greg | Rose Relating to access to and benefits for mental health conditions and substance use HB 10 Effective on 9/1/17 | Muñoz, Jr. | Coleman disorders. This Act takes effect immediately, but only if a specific appropriation for the Price | Turner | White | Relating to the creation of a matching grant program to support community mental HB 13 health programs for individuals experiencing mental illness and the coordination of implementation of the Act is Clardy | Moody certain behavioral health grants. provided in a general appropriations act of the 85th Legislature. Collier | Anderson, Charles Relating to the continuation of certain public benefits, including medical assistance HB 337 "Doc" | Coleman | Longoria Effective on 9/1/17 benefits, for individuals after release from confinement in a county jail. | Phelan Thompson, Senfronia | HB 1600 Price | Lucio III | Bonnen, Relating to certain mental health screenings under the Texas Health Steps program. Effective on 9/1/17 Greg | Wu

Relating to the provision of certain behavioral health services to children, adolescents, SB 74 Nelson Effective immediately and their families under a contract with a managed care organization.

Huffman | Nelson | Relating to the creation of grant programs to reduce recidivism, arrest, and SB 292 Effective on 9/1/17 Schwertner incarceration of individuals with mental illness.

Relating to the authority of emergency medical services personnel of certain SB 344 West Effective immediately emergency medical services providers to transport a person for emergency detention.

Relating to licensing for certain health professions, including an expedited process for SB 674 Schwertner Effective on 9/1/17 certain physicians specializing in psychiatry; authorizing a fee.

Relating to procedures regarding criminal defendants who are or may be persons with SB 1326 Zaffirini a mental illness or an intellectual disability and to certain duties of the Office of Court Effective on 9/1/17 Administration of the Texas Judicial System related to persons with mental illness.

Relating to interactions between law enforcement and individuals detained or arrested This Act takes effect on suspicion of the commission of criminal offenses, to the confinement, conviction, or September 1, 2017, except SB 1849 Whitmire release of those individuals, and to grants supporting populations that are more likely Section 4.03 takes effect to interact frequently with law enforcement. January 1, 2018. Case Study: Center for School Behavioral Health Legislation

House Bill 3853 – Author: Coleman – Relating to the availability of certain behavioral health professionals at certain public schools.

Support list: National Association of Social Workers - Texas Chapter, Texas State Teachers Association, Texas School Alliance, Disability Rights Texas, Children's Defense Fund-Texas, NATIONAL ALLIANCE on Mental Illness (NAMI) Texas, Texas American Federation of Teachers ,Texas Council of Community Centers, Mayor's Office, City of Houston, Methodist Healthcare Ministries of South Texas, Inc., Coalition of Texans with Disabilities, Texans Care for Children, Children at Risk, Easter Seals, Communities for Recovery, United Ways of Texas, Texas PTA, Texas Psychological Association, Association of Texas Professional Educators, Texas Classroom Teachers Association. Case Study: Center for School Behavioral Health Legislation

House Bill 3887 – Author: Coleman – Sponsor: Zaffirini – Relating to trauma training for public school personnel.

Support list: University of Texas Health Science Center at Houston, Texas Counseling Association, Texas PTA, Texas Counseling Association, Coalition of Texans with Disabilities, National Association of Social Workers - Texas Chapter, NATIONAL Alliance on Mental Illness (NAMI) Texas, Association of Substance Abuse Programs, Mayor's Office, City of Houston, American Federation of Teachers, Mexican American Legal Defense and Educational Fund, Texans Care for Children, Texas Suicide Prevention Council, United Ways of Texas

House Local, Consent, and Resolutions Third Reading Vote: – Biedermann, Leach, Phillips, Rinaldi, Schaefer, Tinderholt, and Zedler Senate Education Committee Vote: – Bettencourt, Campbell, Huffines, Hughes Case Study: Center for School Behavioral Health Legislation

House Bill 2623 – Author: Allen | Thompson, Senfronia – Sponsor: Zaffirini – Relating to requiring school districts and certain facilities to assist students in making the transition back to school after certain prolonged placements outside of school.

Support list: Harris County Juvenile Probation Department, Disability Rights Texas, Texas NAACP, One Voice Texas, Texas State Teachers Association, Texas Appleseed, Texas CASA, Coalition of Human Rights Policy Advocates, Texas Counseling Association, Texas Association of School Boards, Houston ISD, Association of Substance Abuse Programs, Mayor's Office, City of Houston, Coalition of Texans with Disabilities, Texas Association for the Protection of Children, Mexican American Legal Defense and Educational Fund, Children at Risk, Texans Care for Children, ACLU of Texas, Communities for Recovery, United Ways of Texas, Texas PTA, Association of Texas Professional Educators.

House Local, Consent, and Resolutions Third Reading Vote: – Biedermann, G. Bonnen, Burrows, Fallon, Goldman, Parker Simmons, Springer, Swanson and Tinderholt Senate Education Committee Vote: – Bettencourt, Campbell, Huffines, Hughes Case Study: Women’s Mental Health

BILL # AUTHOR CAPTION STATUS Relating to coverage for certain services and the Coleman | Farrar | provision of certain information relating to postpartum 05/04/2017 H Committee HB 2135 Guillen depression under the medical assistance and CHIP report sent to Calendars perinatal programs. Davis, Sarah | Relating to coverage for certain services related to Thompson, 06/15/2017 E Effective on HB 2466 maternal depression under the Medicaid and child health Senfronia | Price | 9/1/17 plan programs. Zerwas | Collier Relating to coverage for certain services related to 04/04/2017 H Withdrawn HB 2303 Thierry maternal depression under the Medicaid and child health from schedule plan programs. Relating to a strategic plan to address postpartum 05/03/2017 H Committee HB 2604 Farrar depression. report sent to Calendars Relating to coverage for certain services related to 02/22/2017 S Referred to SB 808 Miles maternal depression under the Medicaid and child health Health & Human Services plan programs. Thierry | Thompson, 05/12/2017 H Returned Senfronia | Johnson, Relating to a study concerning maternal mortality and HB 2403 to Local & Consent Eric | Coleman | morbidity in the state's African American population. Calendars Comm Walle Relating to maternal mortality and morbidity and 05/27/2017 S House SB 1929 Kolkhorst pregnancy-related deaths, including postpartum appoints conferees- depression. reported Lessons Learned: Avoiding Pitfalls

- Direct engagement of the State House of Representatives regarding MH / BH landscape - Strategic messaging and funding solutions to securing and maintaining funding during an economic downturn - Recognition of the dynamic of House versus Senate

- Ongoing efforts to combat existing Senate views on Mental Health legislation as an unfunded mandate, as well as the conflation of maternal mental health legislation with pro-choice legislation